Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2024

Open Access 01-12-2024 | Cystectomy | Research

Feasibility and safety of laparoscopic radical cystectomy for male octogenarians with muscle-invasive bladder cancer

Authors: Dong-liang Pan, Lu-fang Zhang, Xiao-jian Li, Ke-ping Zhang, Peng-fei Gao, Bing Yang, Ning-chen Li

Published in: BMC Cancer | Issue 1/2024

Login to get access

Abstract

This study was designed to evaluate the safety and feasibility of laparoscopic radical cystectomy (LRC) for male octogenarian patients with muscle-invasive bladder cancer (MIBC). Briefly, a total of 57 male octogenarian patients (A group) with bladder carcinoma were enrolled and underwent LRC and intracorporeal pelvic lymph node dissection with bilateral cutaneous ureterostomy from May 2016 to December 2022. Besides, 63 male patients (age < 80 years old) with bladder carcinoma undergoing LRC and 17 octogenarian male patients with bladder carcinoma undergoing open radical cystectomy (ORC) were enrolled in B and C groups as control. All perioperative clinical materials and outcomes of long-term follow-up, and complication were collected. The specific results were shown as follows. Compared with C group, the operation time and resected lymph node in A group was increased, and the estimated blood loss, the number of transfusion needed, duration of pelvic drainage and hospital stay after surgery was decreased. The death rate and ileus complication rate were higher in A group (12 cases) than in C group (15 cases). The cases of ureteral stricture in A group (13 cases) was decreased compared with that in C group. Overall, LRC and bilateral cutaneous ureterostomy are safe, feasible and better choices for the treatment of male octogenarian patients with MIBC. The octogenarian receiving cutaneous ureterostomy heals slowly and exists certain incomplete intestinal obstruction after surgery.
Literature
1.
Stein JP, Lieskovsky G, Cote R, Groshen S, Feng AC, Boyd S, et al. Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol. 2001;19(3):666–75.PubMedCrossRef
2.
World Health Organization Consensus Conference on, Bladder C, Hautmann RE, Abol-Enein H, Hafez K, Haro I, Mansson W et al. Urinary diversion. Urology. 2007;69(1 Suppl):17–49.
3.
Mmeje CO, Benson CR, Nogueras-González GM, Jayaratna IS, Gao J, Siefker-Radtke AO, et al. Determining the optimal time for radical cystectomy after neoadjuvant chemotherapy. BJU Int. 2018;122(1):89–98.PubMedCrossRef
4.
Tang K, Li H, Xia D, Hu Z, Zhuang Q, Liu J, et al. Laparoscopic versus open radical cystectomy in bladder cancer: a systematic review and meta-analysis of comparative studies. PLoS ONE. 2014;9(5): e95667.PubMedPubMedCentralCrossRef
5.
Albisinni S, Rassweiler J, Abbou CC, Cathelineau X, Chlosta P, Fossion L, et al. Long-term analysis of oncological outcomes after laparoscopic radical cystectomy in Europe: results from a multicentre study by the European Association of Urology (EAU) section of uro-technology. BJU Int. 2015;115(6):937–45.PubMedCrossRef
6.
Khan MS, Gan C, Ahmed K, Ismail AF, Watkins J, Summers JA, et al. A single-centre early phase randomised Controlled three-arm trial of Open, robotic, and laparoscopic radical cystectomy (CORAL). Eur Urol. 2016;69(4):613–21.PubMedCrossRef
7.
Khan MS, Omar K, Ahmed K, Gan C, Van Hemelrijck M, Nair R, et al. Long-term oncological outcomes from an early phase randomised Controlled three-arm trial of Open, robotic, and laparoscopic radical cystectomy (CORAL). Eur Urol. 2020;77(1):110–8.PubMedCrossRef
8.
Hautmann RE, de Petriconi RC, Volkmer BG. Lessons learned from 1,000 neobladders: the 90-day complication rate. J Urol. 2010;184(3):990–4; quiz 1235.PubMedCrossRef
9.
Djaladat H, Bruins HM, Miranda G, Cai J, Skinner EC, Daneshmand S. The association of preoperative serum albumin level and American Society of Anesthesiologists (ASA) score on early complications and survival of patients undergoing radical cystectomy for urothelial bladder cancer. BJU Int. 2014;113(6):887–93.PubMedCrossRef
10.
de Vries RR, Kauer P, van Tinteren H, van der Poel HG, Bex A, Meinhardt W, et al. Short-term outcome after cystectomy: comparison of two different perioperative protocols. Urol Int. 2012;88(4):383–9.PubMedCrossRef
11.
Malavaud B, Vaessen C, Mouzin M, Rischmann P, Sarramon J, Schulman C. Complications for radical cystectomy. Impact of the American Society of Anesthesiologists score. Eur Urol. 2001;39(1):79–84.PubMedCrossRef
12.
13.
14.
Froehner M, Brausi MA, Herr HW, Muto G, Studer UE. Complications following radical cystectomy for bladder cancer in the elderly. Eur Urol. 2009;56(3):443–54.PubMedCrossRef
15.
de Sanchez E. [My first steps in laparoscopic surgery]. Arch Esp Urol. 2007;60(8):989–93.
16.
Cusano A, Haddock P Jr, Jackson M, Staff I, Wagner J, Meraney A. A comparison of preliminary oncologic outcome and postoperative complications between patients undergoing either open or robotic radical cystectomy. Int Braz J Urol. 2016;42(4):663–70.PubMedPubMedCentralCrossRef
17.
18.
Davis RB, Farber NJ, Tabakin AL, Kim IY, Elsamra SE. Open versus robotic cystectomy: comparison of outcomes. Investig Clin Urol. 2016;57(Suppl 1):36–43.CrossRef
19.
Muto S, Kitamura K, Ieda T, Shimizu F, Nagata M, Isotani S, et al. A preliminary oncologic outcome and postoperative complications in patients undergoing robot-assisted radical cystectomy: initial experience. Investig Clin Urol. 2017;58(3):171–8.PubMedPubMedCentralCrossRef
20.
Bochner BH, Dalbagni G, Sjoberg DD, Silberstein J, Keren Paz GE, Donat SM, et al. Comparing open radical cystectomy and robot-assisted laparoscopic radical cystectomy: a randomized clinical trial. Eur Urol. 2015;67(6):1042–50.PubMedCrossRef
21.
Tan WS, Khetrapal P, Tan WP, Rodney S, Chau M, Kelly JD. Robotic assisted radical cystectomy with extracorporeal urinary diversion does not show a benefit over open radical cystectomy: a systematic review and meta-analysis of randomised controlled trials. PLoS ONE. 2016;11(11): e0166221.PubMedPubMedCentralCrossRef
22.
Bak DJ, Lee YJ, Woo MJ, Chung JW, Ha YS, Kim HT, et al. Complications and oncologic outcomes following robot-assisted radical cystectomy: what is the real benefit? Investig Clin Urol. 2016;57(4):260–7.PubMedPubMedCentralCrossRef
23.
Pak JS, Lee JJ, Bilal K, Finkelstein M, Palese MA. Utilization trends and short-term outcomes of robotic versus open radical cystectomy for bladder cancer. Urology. 2017;103:117–23.PubMedCrossRef
24.
Rasmussen KC, Hojskov M, Ruhnau B, Salling L, Pedersen T, Goetze JP, et al. Plasma pro-atrial natriuretic peptide to indicate fluid balance during cystectomy: a prospective observational study. BMJ Open. 2016;6(2): e010323.PubMedPubMedCentralCrossRef
25.
Yasui T, Tozawa K, Ando R, Hamakawa T, Iwatsuki S, Taguchi K, et al. Laparoscopic Versus open radical cystectomy for patients older than 75 years: a single-center comparative analysis. Asian Pac J Cancer Prev. 2015;16(15):6353–8.PubMedCrossRef
26.
Winters BR, Bremjit PJ, Gore JL, Lin DW, Ellis WJ, Dalkin BL, et al. Preliminary comparative effectiveness of robotic versus open radical cystectomy in elderly patients. J Endourol. 2016;30(2):212–7.PubMedCrossRef
27.
Tobias-Machado M, Said DF, Mitre AI, Pompeo A, Pompeo AC. Comparison beetwen open and laparoscopic radical cistectomy in a latin American reference center: perioperative and oncological results. Int Braz J Urol. 2015;41(4):635–41.PubMedPubMedCentralCrossRef
28.
Niegisch G, Albers P, Rabenalt R. Perioperative complications and oncological safety of robot-assisted (RARC) vs. open radical cystectomy (ORC). Urol Oncol. 2014;32(7):966–74.PubMedCrossRef
29.
Tang JQ, Zhao Z, Liang Y, Liao G. Robotic-assisted versus open radical cystectomy in bladder cancer: a meta-analysis of four randomized controlled trails. Int J Med Robot. 2018;14(1):e1867.CrossRef
30.
Kingo PS, Norregaard R, Borre M, Jensen JB. Postoperative C-reactive protein concentration and clinical outcome: comparison of open cystectomy to robot-assisted laparoscopic cystectomy with extracorporeal or intracorporeal urinary diversion in a prospective study. Scand J Urol. 2017;51(5):381–7.PubMedCrossRef
31.
Skjold Kingo P, Palmfeldt J, Norregaard R, Borre M, Jensen JB. Perioperative systemic inflammatory response following robot-assisted laparoscopic cystectomy vs. open mini-laparotomy cystectomy: a prospective study. Urol Int. 2017;99(4):436–45.PubMedCrossRef
32.
Lin T, Fan X, Zhang C, Xu K, Liu H, Zhang J, et al. A prospective randomised controlled trial of laparoscopic vs open radical cystectomy for bladder cancer: perioperative and oncologic outcomes with 5-year follow-upt Lin et al. Br J Cancer. 2014;110(4):842–9.PubMedPubMedCentralCrossRef
33.
Pan DL, Liu LD, Guan DL, Na YQ. Application of ileal orthotopic neobladder for male patients of ≥ 70 years old with muscle-invasive urothelial carcinoma of bladder. China Oncol. 2010;20(11):853–6.
34.
Pan DL, Zhang LF, Liao DX, Gao J, Gao X, Song T, et al. Anatomical operations to lessen blood loss in laparoscopic radical cystectomy for male patients with muscle-invasive urothelial carcinoma of bladder. Chin J Clin Oncol Rehabilitation. 2019;26(8):905–9.
35.
DL. Prophylaxis and management of perioperative hemorrhage in retropubic radical prostatectomy. Oncol Translational Med. 2017;3(4):171–5.CrossRef
36.
Lughezzani G, Sun M, Shariat SF, Budaus L, Thuret R, Jeldres C, et al. A population-based competing-risks analysis of the survival of patients treated with radical cystectomy for bladder cancer. Cancer. 2011;117(1):103–9.PubMedCrossRef
37.
Miller DC, Taub DA, Dunn RL, Montie JE, Wei JT. The impact of co-morbid disease on cancer control and survival following radical cystectomy. J Urol. 2003;169(1):105–9.PubMedCrossRef
38.
Haden TD, Prunty MC, Jones AB, Deroche CB, Murray KS, Pokala N. Comparative perioperative outcomes in septuagenarians and octogenarians undergoing radical cystectomy for bladder cancer-do outcomes differ? Eur Urol Focus. 2018;4(6):895–9.PubMedCrossRef
39.
Game X, Soulie M, Seguin P, Vazzoler N, Tollon C, Pontonnier F, et al. Radical cystectomy in patients older than 75 years: assessment of morbidity and mortality. Eur Urol. 2001;39(5):525–9.PubMedCrossRef
40.
Clark PE, Stein JP, Groshen SG, Cai J, Miranda G, Lieskovsky G, et al. Radical cystectomy in the elderly: comparison of clincal outcomes between younger and older patients. Cancer. 2005;104(1):36–43.PubMedCrossRef
41.
May M, Fuhrer S, Braun KP, Brookman-Amissah S, Richter W, Hoschke B, et al. Results from three municipal hospitals regarding radical cystectomy on elderly patients. Int Braz J Urol. 2007;33(6):764-773; discussion 74-6.PubMedCrossRef
42.
Ethun CG, Bilen MA, Jani AB, Maithel SK, Ogan K, Master VA. Frailty and cancer: implications for oncology surgery, medical oncology, and radiation oncology. CA Cancer J Clin. 2017;67(5):362–77.PubMedCrossRef
43.
National Institutes of Health Consensus Development Conference Statement. geriatric assessment methods for clinical decision-making. J Am Geriatr Soc. 1988;36(4):342–7.
44.
Zietman AL, Shipley WU, Kaufman DS. Organ-conserving approaches to muscle-invasive bladder cancer: future alternatives to radical cystectomy. Ann Med. 2000;32(1):34–42.PubMedCrossRef
45.
Garg T, Chen LY, Kim PH, Zhao PT, Herr HW, Donat SM. Preoperative serum albumin is associated with mortality and complications after radical cystectomy. BJU Int. 2014;113(6):918–23.PubMedPubMedCentralCrossRef
46.
Williams SB, Kamat AM, Chamie K, Froehner M, Wirth MP, Wiklund PN, et al. Systematic Review of Comorbidity and competing-risks assessments for bladder Cancer patients. Eur Urol Oncol. 2018;1(2):91–100.PubMedPubMedCentralCrossRef
47.
Mayr R, May M, Martini T, Lodde M, Pycha A, Comploj E, et al. Predictive capacity of four comorbidity indices estimating perioperative mortality after radical cystectomy for urothelial carcinoma of the bladder. BJU Int. 2012;110(6 Pt B):E222-227.PubMed
48.
Morgan TM, Keegan KA, Barocas DA, Ruhotina N, Phillips SE, Chang SS, et al. Predicting the probability of 90-day survival of elderly patients with bladder cancer treated with radical cystectomy. J Urol. 2011;186(3):829–34.PubMedPubMedCentralCrossRef
49.
Abdollah F, Sun M, Schmitges J, Thuret R, Djahangirian O, Jeldres C, et al. Development and validation of a reference table for prediction of postoperative mortality rate in patients treated with radical cystectomy: a population-based study. Ann Surg Oncol. 2012;19(1):309–17.PubMedCrossRef
50.
Koppie TM, Serio AM, Vickers AJ, Vora K, Dalbagni G, Donat SM, et al. Age-adjusted Charlson comorbidity score is associated with treatment decisions and clinical outcomes for patients undergoing radical cystectomy for bladder cancer. Cancer. 2008;112(11):2384–92.PubMedCrossRef
51.
Bolenz C, Ho R, Nuss GR, Ortiz N, Raj GV, Sagalowsky AI, et al. Management of elderly patients with urothelial carcinoma of the bladder: guideline concordance and predictors of overall survival. BJU Int. 2010;106(9):1324–9.PubMedCrossRef
52.
Yoo S, You D, Jeong IG, Hong JH, Ahn H, Kim CS. Does radical cystectomy improve overall survival in octogenarians with muscle-invasive bladder cancer? Korean J Urol. 2011;52(7):446–51.PubMedPubMedCentralCrossRef
53.
Hall WH, Ramachandran R, Narayan S, Jani AB, Vijayakumar S. An electronic application for rapidly calculating Charlson comorbidity score. BMC Cancer. 2004;4: 94.PubMedPubMedCentralCrossRef
54.
Kouba EJ, Wallen EM, Pruthi RS. Gum chewing stimulates bowel motility in patients undergoing radical cystectomy with urinary diversion. Urology. 2007;70(6):1053–6.PubMedCrossRef
55.
Karl A, Buchner A, Becker A, Staehler M, Seitz M, Khoder W, et al. A new concept for early recovery after surgery for patients undergoing radical cystectomy for bladder cancer: results of a prospective randomized study. J Urol. 2014;191(2):335–40.PubMedCrossRef
56.
Xu W, Daneshmand S, Bazargani ST, Cai J, Miranda G, Schuckman AK, et al. Postoperative Pain Management after Radical Cystectomy: comparing traditional versus enhanced recovery protocol pathway. J Urol. 2015;194(5):1209–13.PubMedCrossRef
57.
Stein JP, Skinner DG. Radical cystectomy for invasive bladder cancer: long-term results of a standard procedure. World J Urol. 2006;24(3):296–304.PubMedCrossRef
58.
Hautmann RE, de Petriconi RC, Pfeiffer C, Volkmer BG. Radical cystectomy for urothelial carcinoma of the bladder without neoadjuvant or adjuvant therapy: long-term results in 1100 patients. Eur Urol. 2012;61(5):1039–47.PubMedCrossRef
59.
Nielsen ME, Mallin K, Weaver MA, Palis B, Stewart A, Winchester DP, et al. Association of hospital volume with conditional 90-day mortality after cystectomy: an analysis of the National Cancer Data Base. BJU Int. 2014;114(1):46–55.PubMedPubMedCentralCrossRef
60.
Porter MP, Gore JL, Wright JL. Hospital volume and 90-day mortality risk after radical cystectomy: a population-based cohort study. World J Urol. 2011;29(1):73–7.PubMedCrossRef
61.
Jentzmik F, Schrader AJ, de Petriconi R, Hefty R, Mueller J, Doetterl J, et al. The ileal neobladder in female patients with bladder cancer: long-term clinical, functional, and oncological outcome. World J Urol. 2012;30(6):733–9.PubMedCrossRef
62.
Hautmann RE, Abol-Enein H, Davidsson T, Gudjonsson S, Hautmann SH, Holm HV, et al. ICUD-EAU International Consultation on bladder Cancer 2012: urinary diversion. Eur Urol. 2013;63(1):67–80.PubMedCrossRef
63.
Hautmann RE, Volkmer B, Egghart G, Frohneberg D, Gottfried HW, Gschwend J, et al. Functional outcome and complications following Ileal Neobladder Reconstruction in male patients without Tumor recurrence. More than 35 years of experience from a single Center. J Urol. 2021;205(1):174–82.PubMedCrossRef
64.
Cochetti G, Paladini A, Del Zingaro M, Ciarletti S, Pastore F, Massa G, et al. Robot-assisted radical cystectomy with intracorporeal reconstruction of urinary diversion by mechanical stapler: prospective evaluation of early and late complications. Front Surg. 2023;10: 1157684.PubMedPubMedCentralCrossRef
65.
Soukup V, Babjuk M, Bellmunt J, Dalbagni G, Giannarini G, Hakenberg OW, et al. Follow-up after surgical treatment of bladder cancer: a critical analysis of the literature. Eur Urol. 2012;62(2):290–302.PubMedCrossRef
66.
Faraj K, Chang YH, Neville MR, Blodgett G, Etzioni DA, Habermann EB, et al. Robotic vs. open cystectomy: how length-of-stay differences relate conditionally to age. Urol Oncol. 2019;37(6):354 e1-e8.CrossRef
Metadata
Title
Feasibility and safety of laparoscopic radical cystectomy for male octogenarians with muscle-invasive bladder cancer
Authors
Dong-liang Pan
Lu-fang Zhang
Xiao-jian Li
Ke-ping Zhang
Peng-fei Gao
Bing Yang
Ning-chen Li
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2024
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-024-11816-7

Other articles of this Issue 1/2024

BMC Cancer 1/2024 Go to the issue

Research

Investigation of ENO2 as a promising novel marker for the progression of colorectal cancer with microsatellite instability-high

Research

Survival time prediction in patients with high-grade serous ovarian cancer based on 18F-FDG PET/CT- derived inter-tumor heterogeneity metrics

Correction

Correction: Impact of preoperative antiviral therapy on the prognosis of hepatitis B virus-related hepatocellular carcinoma

Research

Gut microbiota in patients with prostate cancer: a systematic review and meta-analysis

Research

Knockdown of CENPM activates cGAS-STING pathway to inhibit ovarian cancer by promoting pyroptosis

Research

Effect of trace element mixtures on the outcome of patients with esophageal squamous cell carcinoma: a prospective cohort study in Fujian, China
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits